FDA Adverse Event Malfunction Summary report: N

TAMPAXTAMPONSRADIANTRADIANTMIXEDUNSCNT28CT

MDR report key: 20300914 · Received September 25, 2024

Report

Report Number
1219109-2024-00307
Event Type
Malfunction
Date Received
September 25, 2024
Report Date
November 20, 2024
Manufacturer
TAMBRANDS MANUFACTURING, INC
Product Code
HEB
PMA / PMN Number
K110669
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

NO FAILURE COULD BE IDENTIFIED AS A RESULT OF THE INVESTIGATION.

Additional Manufacturer Narrative · 0

PRODUCT INVESTIGATION IS IN PROGRESS.

Additional Manufacturer Narrative · 0

PRODUCT INVESTIGATION IS IN PROGRESS.

Description of Event or Problem · 0

TAMPON FELL APART INSIDE OF ME [FOREIGN BODY IN REPRODUCTIVE TRACT], TAMPON FELL APART, BIG PIECES THAT BROKE OFF [DEVICE BREAKAGE], WHEN I WENT TO TAKE IT OUT IT FELL APART INSIDE OF ME [COMPLICATION OF DEVICE REMOVAL] . CASE NARRATIVE: CONSUMER REPORTED VIA PHONE THAT WHEN SHE TOOK OUT THE TAMPON IT FELL APART INSIDE OF HER. NO SERIOUS INJURY WAS REPORTED.

Description of Event or Problem · 0

TAMPON FELL APART INSIDE OF ME [FOREIGN BODY IN REPRODUCTIVE TRACT]. TAMPON FELL APART, BIG PIECES THAT BROKE OFF [DEVICE BREAKAGE]. WHEN I WENT TO TAKE IT OUT IT FELL APART INSIDE OF ME [COMPLICATION OF DEVICE REMOVAL]. CASE NARRATIVE: CONSUMER REPORTED VIA PHONE THAT WHEN SHE TOOK OUT THE TAMPON IT FELL APART INSIDE OF HER. NO SERIOUS INJURY WAS REPORTED.

Description of Event or Problem · 0

TAMPON FELL APART INSIDE OF ME [FOREIGN BODY IN REPRODUCTIVE TRACT]. TAMPON FELL APART, BIG PIECES THAT BROKE OFF [DEVICE BREAKAGE]. WHEN I WENT TO TAKE IT OUT IT FELL APART INSIDE OF ME [COMPLICATION OF DEVICE REMOVAL]. CASE NARRATIVE: CONSUMER REPORTED VIA PHONE THAT WHEN SHE TOOK OUT THE TAMPON IT FELL APART INSIDE OF HER. NO SERIOUS INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2199138 TAMPAXTAMPONSRADIANTRADIANTMIXEDUNSCNT28CT TAMPON, MENSTRUAL, UNSCENTED - HEB HEB TAMBRANDS MANUFACTURING, INC 3073243022101231

Patients

Seq Age Sex Outcome Treatment
1 NA Female